Editor(s)

Syed A. A. Rizvi
Professor,
Department of Pharmaceutical Sciences, Hampton University School of Pharmacy (HUSOP) Flemmie P. Kittrell Hall, 121 William R. Harvey Way, Hampton, VA 23668, USA.

ISBN 978-93-91595-82-1 (Print)
ISBN 978-93-91595-90-6 (eBook)
DOI: 10.9734/bpi/nfmmr/v6

This book covers key areas of medicine and medical research. The contributions by the authors include animal models, dental research, diabetes mellitus, blood sugar, calf contractions, pectoral pressure, shoulder squeezes, adsorption, biochar, protein, refolding, thermal stabilization, operation records, fine needle aspiration cytology, sensitivity, specificity, diagnostic accuracy, diuretics, antihypertensive effect, hydrochlorothiazide, chlorthalidone, hypokalemia, physiology, pathology, traditional Chinese medicine, meridians, acupoints, ligaments, caesarean section, vaginal births, vagina and neovagina, vaginoplasty, syndrome, McIndoe, condom, Amniotic membrane, Paraffin gauze, dental charting, Incisor, contraception, urinary stress incontinence, fertility awareness method, molecular genetics, reactive oxygen species, machine learning, palliative care, Biceps Femoris, aberrant frenum, diastema, frenectomy, Millers technique, autopsy, head injury, skull fracture, intracranial hemorrahge, subarachnoid hemorrahage, subdural hemorrhage, extradural haemorrhage, antiphospholipid antibodies, coagulation, thrombosis, pregnancy, Takayasu’s arteritis, C reactive protein, serrum ferritin, Doppler method, cardiomegaly, obstetrics, gynaecology, pediatric brain tumor, tumor classification, survival assessment. This book contains various materials suitable for students, researchers and academicians in the field of medicine and medical research.

 

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Chapters


A Review of Animal Models in Dental Research

Sivaramakrishnan Muthanandam, Jananni Muthu

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 1-6
https://doi.org/10.9734/bpi/nfmmr/v6/3531F

Animals have been used in the service of mankind since time immemorial. Though animals appear different from humans, they share same systemic, physiologic and metabolic characteristics with the advancement of science, the use of animals has expanded into the field of research as well. Numerous animal species are bred in laboratories for research purposes, and selecting the right animal for dental research remains a challenge. This review focuses on the animal models that are available for dental research.

Manoeuvres for Diabetes Management

Amod Hansdak

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 7-8
https://doi.org/10.9734/bpi/nfmmr/v6/12097D

Diabetes is a rapidly growing global health problem not only leading to significant morbidity and mortality to those affected by it but also places a heavy economic burden on families, societies and governments at large. In the absence of an effective cure, diabetes can only be managed by lifestyle modifications, changed dietary habits and medications. All of them have their own merits and demerits. Herein are proposed manoevres that can be done anywhere, anytime by anyone activating different groups of muscles leading to reduction in blood sugar levels.

The heat stress tolerance of hen egg white lysozyme (HEWL) was dramatically enhanced by the adsorption of HEWL on adzuki bean charcoal powder (ABCP), which was prepared from adzuki bean waste by pyrolysis without combustion under a nitrogen atmosphere and then comminution with a jet mill. HEWL was firmly adsorbed on ABCP even at high temperatures. The remaining activity of HEWL adsorbed on ABCP exhibited 30% just after the incubation for 30 min at 90oC, increased with incubation time at 25oC, reached a plateau at 30 min, and became around 50%. On the other hand, there is almost no remaining activity of native HEWL just after the incubation for 30 min at 90oC, and it did not change by the incubation at 25oC. The thermal denaturation curve of HEWL adsorbed on ABCP was shifted to high temperatures, compared to that of native one. Moreover, the half-life of BCP-adsorbed HEWL was 28 min at 90oC while that of native one was 4 min.

Operative Notes in Surgery

F. Huda, A. Rai, R. Mishra

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 21-28
https://doi.org/10.9734/bpi/nfmmr/v6/11894D

Operation notes are essential documents in the surgical journey of a patient. Despite being essential, it is left to be written by surgical residents. The Royal College of Surgeons guidance, Good Clinical Practice, with its most recent version in 2014, dictates that surgeons must ensure that all medical records are accurate, comprehensive, legible, and contemporaneous. Improving the quality of operation notes automatically improves communication among healthcare workers and helps prevent errors and litigations.

Aims and Objectives: 1.To compare the results of fine needle aspiration cytology (FNAC) and histopathological study of biopsy in detecting breast cancer in suspicious breast lumps in outpatient setting; 2. To study the accuracy of FNAC in diagnosing various breast lumps; 3. To know whether the cancer patients can be managed based on FNAC diagnosis alone without histological study.

Methodology: It was a hospital based retrospective study carried out from the data retrieved from the Dept. of Pathology of Mysore Medical College, Mysore in a period from August 2016 – September 2016.

Period of Study: 2 months, Sample Size: 50 patients.

Results: In the present study, FNAC had sensitivity of 50%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 88.37%. In this case FNAC is highly specific with maximum positive predictive value.

Conclusion: Benign neoplasms of the breast are more common than malignant one. The present study shows FNAC correlation with histopathology with high specificity and maximum positive predictive value. The sensitivity of FNAC is less compared to biopsy. However, FNAC can be used as an indicative diagnosis (one stop) for breast cancer examination in outpatient setting. Accuracy of FNAC enables to proceed with surgery or not. It bridges the gap between clinical evaluation and final surgical pathological diagnosis in majority of cases. It enables the clinician to obtain a diagnosis in high percentage of cases with minimal expenditure of time, and money and often to avoid unnecessary surgery.

Effect of Hydrochlorothiazide and Chlorthalidone on Recently Diagnosed Hypertensives: A Comparative Approach

Bijay Kumar, Sharanjit Kaur, Sami Manzoor, Harinder Jot Singh

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 41-48
https://doi.org/10.9734/bpi/nfmmr/v6/1838C

Background: Hydrochlorthiazide and chlorthalidone are the two thiazides which are routinely used in hypertension. Metabolic abnormities especially hypokalaemia can be minimsed with the use of chlorthalidone which is more potent and longer acting.

Objective: Thiazide diuretics have been the first choice to treat stable, uncomplicated, essential hypertension; hydrochlorothiazide (HCTZ) being the most preferred. Another thiazide, chlorthalidone is available since long and is reported to be equally efficacious if not better in treating primary hypertension.

Aim: To compare the efficacy and safety of HCTZ and chlorthalidone in the management of primary essential hypertension.

Methods: We compared these two drugs in a randomized, single-blinded, intention to treat study. Participants with essential hypertension received either chlorthalidone 12.5 mg OD or HCTZ 25 mg OD for a period of 12-week. The results were compared on the basis of 12 hourly ambulatory blood pressure (BP) monitoring; fortnightly record of serum potassium, and failure of treatment (i.e., the need of additional antihypertensive drug or incrementation in the dose of thiazides).

Results: Out of 114,44 in chlorthalidone group and 39 in HCTZ group completed our study. There was a significant mean fall in BP by -11.89/-9.86 in the morning time and by -11.12/-7.56 in the evening time in group H receiving HCTZ 25 mg OD. In chlorthalidone group, this mean fall was by-16.45/-12.38 in the morning time and by -15.73/-10.86 in the evening time. After 12 weeks, night time BP control was better in chlorthalidone group (127.91±5.01) than HCTZ (132.67±5.19) (p=0.001). Both drugs decreased serum potassium levels, but this decrease was marginally more with HCTZ (3.777±0.601 vs. 3.891±0.534), statistically non-significant when compared to each other (p>0.05).

Conclusion: Chlorthalidone is better than HCTZ in controlling BP throughout the day without causing any significant complication.

New Discovery of the Effect of Acupoints on the Human Body

Li Xiaoguang

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 49-55
https://doi.org/10.9734/bpi/nfmmr/v6/3810F

Modern medicine tells us that the human body is an organism composed of heart, lungs, liver, kidneys, spleen, stomach, brain, nerves, muscles, bones, blood vessels, blood and so on, but Traditional Chinese Medicine believes that besides these tissues and organs, the human body still has another part of the structure, Traditional Chinese Medicine calls them Jing Luo and Shu Xue. Jing Luo means the longitudinal line of the human body and the accompanying net, translated into English Meridians and Collaterals. Shu Xue means holes distributed on Jing Luo and outside Jing Luo, because stimulating Shu Xue's position by acupuncture, massage and other methods can cure diseases, so Shu Xue is translated into an English acupuncture point, abbreviated as acupoint or point. Meridians and acupoints are the special knowledge of the human body structure in Traditional Chinese Medicine. Traditional Chinese Medicine not only draws the distribution map of the meridians and acupoints in the human body, but also has been using them to treat diseases for thousands of years. There are hundreds of these acupoints, stimulating each one by acupuncture, massage or other methods will have a special effect on the human body and can treat various diseases. But what effect does stimulating every acupoint have on the human body so that it can treat various diseases? The discussion of Traditional Chinese Medicine is vague and incomprehensible, and can not be proved by experiments.

According to the author's research for more than 30 years, this paper makes a clear and accurate exposition of the effects on the human body and diseases that can be treated with acupoint massage. These statements can be proved by experiments, so they are believed to be reliable. It is hoped that meridians, acupoints and massage therapy can be incorporated into modern medicine and become a part of modern medicine in the future after the contents of this paper be proved by others through experiments.  

Massaging acupoints can not only treat many diseases that are difficult to be treated with drugs, but also have simple methods and low cost.

A Dilemma for Modern Obstetrics -Rising Incidence of Caesarean Section Rate

Zahra Safdar, Sumera Zaib

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 56-63
https://doi.org/10.9734/bpi/nfmmr/v6/3796F

Objectives: To study the rate of caesarean sections (indications, ratio in emergency and elective caesarean sections) the percentage of vaginal birth after caesarean sections and instrumental deliveries.

Methods: This retrospective study was conducted over a period of one year from 1st January 2018 to 31st December 2018 at the Department of obstetrics and gynaecology, unit 2, Lahore general hospital, Lahore. The data of obstetrical patients who got admitted in the unit and were delivered either vaginally or through abdominal route during the defined study period was recorded and a statistical analysis of various parameters namely the caesarean section rates, its indications, the ratio of emergency and elective caesarean sections, the rate of vaginal births after caesarean section (VBACS) and instrumental deliveries was done.

Results: The total numbers of obstetrical patients admitted over the study period were 18183. Out of which total deliveries were 6602, vaginal births were 3699 and caesarean sections were 2765. The overall caesarean section rate was 41.88%, elective sections were 473(17.1%) and emergency sections were 2292(82.89%). The vaginal births were 3699(56.02%), VBACS were 98(2.6%), instrumental deliveries like forcep deliveries were 31(0.8%) and ventouse deliveries were 47(1.2%). There were 38(1.02%) twin deliveries and 59(1.5%) assisted breech deliveries. The caesarean sections done electively as well as in emergency with different indications were calculated individually.

Conclusions: The rising incidence of caesarean section is most pressing fact of the decade in modern obstetrics. The detailed audit of the caesarean sections done over a year in a tertiary care hospital showed a large number of sections done due to fetal distress. The confirmation of its diagnosis to prevent unnecessary surgeries is pivotal. The previous scars and indications related to them are the most important component in the study so concluding this study to take steps in prevention of primary caesarean section is foremost. Audit and surveillance of caesarean sections should be carried out annually to identify the preventable causes of caesarean sections.

Current Research on Modifications and Innovations in Mc Indoe Vaginoplasty for Better Outcomes

Chanjiv Singh Mehta, Gursehaj Mehta

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 64-72
https://doi.org/10.9734/bpi/nfmmr/v6/11742D

Vaginal agenesis is one of the most common female genital disorders. It may be an isolated problem or part of a syndrome. Apart from congenital causes, there are many other indications for vaginal reconstruction. Diagnosed late and having complex psychological issues, the reconstruction to provide a normal functioning vagina is a challenge. Although numerous techniques are described, there appears to be no consensus on which is the ideal one. Nor is there one opinion on when the reconstruction should be taken up. The McIndoe technique 22, 26, 27, has been used over the ages with success. Many modifications 45, 47 have been described. The present paper describes some modifications with which better results can be achieved consistently with this technique. To optimize sexual comfort, the clinical management of women with vaginal agenesis must be multidisciplinary and individually tailored.

MICAP Tooth Notation

Ashfaq Akram, Melinda Madlena, Ulfat Bashir, Thirupathi Vishnumukkala, Maher D. Fuad

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 73-80
https://doi.org/10.9734/bpi/nfmmr/v6/3093F

Background: Universal system, Palmer notation and FDI system are used to record dental problems which give different numbers to the same tooth. For example, the central incisor is #8 (Universal system) and #11 (FDI system). Thus, they create confusion in transferring dental information to represent the maxillary and mandibular teeth, the letters I-incisor, C-canine, P-premolar, M-molar, and the numerals 1, 2, 3 are displayed as superscript and subscript on the corresponding letters (I, C, P, M) making up a new tooth notation called MICAP.

Aim: The purpose of this study is to assess the learning of the format of the MICAP system by students of undergraduate dental degree and dental allied health programs using a mock MICAP dental chart.

Materials and Methods: A mock MICAP dental chart was created. After an hour lecture and video demonstration about the MICAP format, students of undergraduate dental degree [group A (n=39)] and dental allied health program [group B (n=39)] who were further subdivided based on age such as [group 1=15-25 years, group 2=26-35 years, group 3=36-45 years], translated four MICAP symbols and vice versa in a cross-sectional study. To analyze the data, a one-way ANOVA and an independent t-test were used.

Results: Group A outperformed Group B [mean difference 95% CI: -0.128 (-0.285, 0.028) p=0.001] in translation of #1C (maxillary right canine). In terms of age, group 1 performed better in MICAP format translation (p<0.001) than the other groups. More than half of the participants agreed that the MICAP notation system was simple to grasp.

Conclusion: The new notation format is simple to grasp. A new method for identifying teeth has been developed.

Study on Multipurpose, Reusable, Female Contraceptive Device for Enhancing the Effectiveness of Fertility Awareness Methods and Controls Stress Incontinence

Shihata Alfred, A. Brody Steven, Linderoth Birgit, Julia Barrett

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 81-89
https://doi.org/10.9734/bpi/nfmmr/v6/1836C

Introduction: The Fertility awareness method is the safest and the most cost-effective of all contraceptive options, yet it is the least prescribed by doctors and the least used by women. Stress Urinary Incontinence (SUI) is very prevalent among women of all ages, particularly menopausal women. There is a significant deficiency in women’s reproductive health needs: 1) Lack of options of non-hormonal contraceptive methods. 2) Fertility awareness method is the safest and yet it is rarely utilized. 3) Women suffer from Stress Incontinence silently.

Objectives: To provide women with one device that can be used for 1) Contraception by stopping sperm from entering the cervix, 2) To enhance the effectiveness of Fertility Awareness Methods by accurately detecting ovulation day and 3) Control Stress Urinary Incontinence by supporting the bladder neck.

Materials and Methods: We selected the FDA approved FemCap contraceptive device to determine its utility to fulfill the three basic reproductive health needs for women. 1) The FemCap is a safe and effective, time tested, barrier contraceptive device. 2) The FemCap can collect a large amount of fertile cervical mucous, that is not mixed with vaginal secretions. 3) The use of currently available pessaries have significant limitations such as displacement, erosion or even ulceration and urethral obstruction. The FemCap resembles the ring pessary with support in appearance. The FemCap's Rim is shaped and functions similarly to the pessary's ring, which supports the bladder neck. The urethra and vaginal anatomy are restored by the outward flared brim. The bowl of the FemCap supports the cervix and prevents it from descending, which is like the supported pessary.

Results: Women using the FemCap identified their preovulatory cervical secretions in 96% of cases. They also verified their ovulation by a positive urinary L.H. surge (Luteinizing Hormone). The FemCap is a well-established barrier contraceptive device. It is also has proven in pilot studies to enhance the effectiveness of fertility awareness methods and control stress incontinence.

Conclusion: It would be ideal and cost effective for women to acquire one multipurpose reusable device that can be used for contraception to enhance fertility awareness and to control stress incontinence.

Determining the Physiological Mechanisms Involved in Longer Life Span!

Kartheek R. Balapala, Victor Mwanakasale

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 90-99
https://doi.org/10.9734/bpi/nfmmr/v6/3716F

Ageing is undoubtedly the most perplexed phenotype occurring among humans. For comprehensive treatment of ageing as well as associated diseases, highly specialized technologies are emerging that reveal critical insight into the underlying mechanisms and giving a novel hope for previously untreated diseases. Previous research has found a link between human social relationships and longevity. In old age, there is a decline in mitochondrial activity as well as changes in nuclear chromatin. Multiple organ failure is connected with animal ageing, but age-related degeneration is the primary component in human ageing. Naked mole-rats with low amounts of circulating methionine survived longer, suggesting they exhibited a natural life-extension phenotype similar to that seen in methionine-restricted animals. A longer life span was achieved as a result of health-improving measures. Humans of various families have variable rates of ageing, and those with exceptional survival offer hope for understanding why some people age more slowly than others.The goal of this study is to discover the most important characteristics that increase longevity. Herein, are described the latest developments in cutting edge technologies applied across the domain of ageing research including the emerging model organisms, high-throughput methodologies and machine-driven approaches. In all, this body of writing will provide you a glimpse of what will be pushing the field upwards and onwards.

Analysis of Motivational Interviewing in Pro-Life Palliative Care

Tiffany A. Riebel

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 100-113
https://doi.org/10.9734/bpi/nfmmr/v6/3682F

Pro-life practitioners must make integrous or endogenic, a respect for life from the moment of conception until natural death. With true belief and faith in the pro-life cause, the practitioner imbues with patience and encouragement the fruits necessary to begin the process of motivational interviewing toward life for their patients. Natural death does not refer to a lack of medication or lack of intervention, but rather the opposite, natural death, or the end-of-life after every effort and intervention has been made to prolong a life. The word ‘integrous’ is rooted from the word ‘integrity’ or virtue; the human virtue needed to apply effortful moral value in the practice of pro-life health care. The pro-life practitioner, with steadfast balance and resolute belief for each life for which they care, seeks to prolong every life until the end or natural death. With the integrous belief in life, the pro-life practitioner will develop internal motivations in patients for living and effective management of any disease course. In this article, the components of the therapeutic modality of Motivational Interviewing (a.k.a motivational counseling or coaching) in the context of end-of-life care will be explained in light of a pro-life palliative health care practice.

A Case Report on Third Head of Biceps Femoris Muscle

Surajit Ghatak, Sonali Adole, Debajani Deka, Md Faizal

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 114-120
https://doi.org/10.9734/bpi/nfmmr/v6/3606F

Biceps femoris variants, such as an accessory head of biceps femoris, can be seen on sometimes. We identified a case with an accessory head of biceps femoris in both lower limbs during normal cadaveric dissection in the department of anatomy, All India Institute of Medical Sciences, Jodhpur.

The muscle belly originates from the fibres of the long head of the biceps femoris and goes downward medially to the medial superior aspect of the tibia's medial condyle. The insertion point on the right side looks like a sheath, and it merges halfway with the medial intermuscular septum of the thigh. The insertion on the left side looks like a thin sheath at first, then a thin muscle belly. In comparison to the long and short heads of the primary muscle bellies, the muscle belly is thin. The thickness on the left side is around 3.7mm on the higher end and thinner on the lower end, while the thickness on the right side is also around 3.75mm.  The length of the muscle belly on the right side is around 5cm, while on the left side it is around 5.5cm. The muscle belly then becomes a sheath with a length of around.5mm, before returning to a length of around 3.5cm.On the left side, a short head appears high above, whereas the right side is normal.

A Case Report on Frenectomy by Millers Technique

Nishita Bhosale, Yogesh Khadtare, Pramod Waghmare, Amit Chaudhari, Priya Lele

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 121-127
https://doi.org/10.9734/bpi/nfmmr/v6/3718F

Background: The Aberrant labial frenum results in diastema and gingival recession thereby compromising the esthetic and functional needs of the patient. The classical frenectomy technique by Archer is an extensive procedure which results in Unaesthetic scaring of the tissue, loss of interdental papilla. To overcome these drawbacks, Miller introduced a newer technique where he combined the frencetomy technique with laterally displaced flap. The main advantage of this technique is that the healing takes place by primary intention with no scaring of the tissue. Therefore the Aim of the present study is to find out whether Frenectomy by millers technique overcomes the drawbacks of the classical technique.

Materials and Methods: 23 year old male patient with abnormal frenum was selected for frenectomy by miller’s technique.

Conclusion: The main advantages of this technique is healing by primary intention, no scaring, and formation of thick zone of attached gingiva. We were able to achieve the above in our case.

Study on Pattern of Hanging Cases Brought for Autopsy at a Tertiary Care Centre in Central India

Avinash H. Waghmode, Anil J. Anjankar

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 128-133
https://doi.org/10.9734/bpi/nfmmr/v6/3467F

This study is the retrospective study carried out in the Department of Forensic medicine and Toxicology at a Tertiary Care Centre during the period June 2016 to June 2017. All the cases with alleged history of hanging cases are included in this study. Aims and objectives of the present study are to determine Age and Sex wise distribution of hanging cases, type of ligature material used and reason for committing suicide. In the present study 31 to 40 year was the most commonly involved age group followed by 51-60 years and 41-50 years in which male outnumbered the female. Complete hanging was seen in 75% deaths. Nylon rope is the most commonly used material for hanging. Evidence of salivary stains around the angle of mouth is present in 25% of the cases. In 87.5% of cases the ligature mark is present above the level of thyroid cartilage. The most common reason for hanging deaths is the financial problems (75.83%). The incidence of hanging is more common in Married people than unmarried people.

Pattern of Head Injury Cases Admitted at Tertiary Care Centre in Central India: A Cross Sectional Study

Avinash H. Waghmode, Prakash M. Mohite

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 134-140
https://doi.org/10.9734/bpi/nfmmr/v6/3468F

The present was the prospective study prospective on head injury cases admitted at tertiary care centre. Cases with the history of head injury which are admitted to the hospital are included in this study. The cases which were brought dead and which were having other visceral injury other than brain are excluded from this study. The present study was carried out in the department of Forensic medicine and Toxicology, Indira Gandhi Government Medical College, Nagpur during the period of November 2011 to October 2013. Aim of this study was to asses the age and sex wise distribution of head injury cases, type of skull fracture and intracranial hemorrage, survival time. In the present study 21 to 30 year was the most commonly involved group in which male outnumbered the female. Out of 103 cases, road traffic accident was the most common cause of head injury followed by fall from height and assault. Most of the cases (i.e.61 cases) died during the first 24 hours of admission. Fissured (Linear) fracture was the most common type of skull fracture observed in the present study (41.35% cases). Temporal bone was the most common bone involved. Subdural and subarachnoid haemorrhages are the most common type of intracranial haemorrhage observed in the present study.

Studies on Antiphospholipid Syndrome

Cacciola Rossella, Gentilini Cacciola Elio, Cacciola Emma

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 141-148
https://doi.org/10.9734/bpi/nfmmr/v6/3885F

The antiphospholidid syndrome (APS) is a rare and poorly understood clinical condition with potentially devastating consequences. It is defined by the presence of so-called antiphospholipid antibodies (aPL). These autoantibodies are not directed against anionic phospholipids but rather against plasma proteins with high affinity for anionic phospholipids. The cardinal manifestations are arterial and venous thrombosis and pregnancy morbidity. Other manifestations include catastrophic APS or immune thrombocytopenia. The laboratory tests exploring the presence of aPL include lupus anticoagulant (LA), anticardiolipin (aCL), and anti-b-2-glycoprotein I (a-b2GPI) antibodies. Laboratory tests may be positive in different combinations and in individuals having positivity for all 3 laboratory tests  (triple positivity) are at the highest risk for a first thrombotic event and recurrence. The indefinite anticoagulant treatment with warfarin prevent the thrombotic recurrences.

A Typical Presentation of Takayasu’s Arteritis – Takayasu’s Arteritis: An Approch to Dilated Cardiomyopathy

R. K. Vidyabati Devi, Rothang Pui, William Loitam

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 149-152
https://doi.org/10.9734/bpi/nfmmr/v6/3630F

Background: Takayasu vasculitis is a rare type of large vessel vasculitis that primarily affects the aorta and its main branches; signs and symptoms are usually due to systemic inflammation or ischemia of an organ depending on the group of blood vessels involved. Takayasu arteritis is associated with increased platelet and coagulation activity, leading to a hypercoagulable. We report a young female of 20 year old was diagnosed with Takayasu’s arteritis based on clinical features, investigations and resolution of symptoms with steroids. In addition to clinical examination and imaging studies, laboratories studies such as C Reactive protein and serum ferritin may aid in support of a diagnosis of large vessel vasculities. This is a rare presentation of Takaysu’s arteritis which illustrated that Takaysu’s arteritis can have varied presentation.

Aim and Objectives: Early diagnosis along with treatment to improved the symptoms. To prevent the classical manifestation of Takayasu’s arteritis.

Conclusion: In patients with markedly raised serum ferritin, creative proteins in the appropriate clinical setting. Consideration should be given to the diagnosis of Takayasu Arteritis echocardiography should be done. This may aid in early initiation of appropriate therapy.

This is a prospective randomized control which studies intravenous tranexamic acid administration and its role in minimising blood loss in caesarean delivery. The study was carried out in the department of Obstetrics and Gynaecology (inpatient only) of Central Hospital, South Eastern Railways, Kolkata from August 2018 to August 2020. Our objectives were to compare the amount of blood loss during caesarean section between patients receiving intravenous tranexamic acid and placebo (Normal Saline) and comparing the amount of blood loss 2 hours after caesarean section between patients receiving intravenous tranexamic acid and placebo. The patients were selected randomly and assigned into two groups. The study concluded that prophylactic use of tranexamic acid significantly reduces the amount of blood loss during and after lower segment caesarean section.

Multivariate Analysis in Pediatric Brain Tumor Research

Jing Zhang

New Frontiers in Medicine and Medical Research Vol. 6, 2 August 2021, Page 166-179
https://doi.org/10.9734/bpi/nfmmr/v6/3913F

Children's brain tumours are life-threatening, and more research is needed to improve patient care. Multivariate analysis has been more popular in recent years for tumour categorization (segmentation) and survival (outcome) assessment in children with brain tumours. This paper reviewed studies that applied multivariate analysis to pediatric brain tumor research in order to provide an overview of the field. In tumour classification investigations, large variability in tumour categorization outcomes were discovered. In addition, there was moderate error rate in the multivariate survival analysis model, which could lead to inaccurate survival estimates and misidentification of prognostic factors. To address these issues, this paper examined the data processing chains in these multivariate analyses in depth, suggesting that optimising and standardising these data processing chains could improve tumour classification and survival analysis, as well as reduce variations and errors in classification and survival estimates. In the Big Data era of the twenty-first century, as multivariate analytic approaches, data processing technologies, and imaging techniques advance, it is expected that the challenges in complex imaging data processing in tumour classification will be overcome, and complex data processing will be revolutionised. This will allow for accurate automatic tumour classification/segmentation, which will aid in the early detection and treatment of cancers, as well as the planning of therapy and monitoring of tumour progression and treatment effects. Further, with the advances of survival assessment to guide life-saving rescue and recovery planning, multivariate analytic methods and technologies will help revolutionize patient care, and truly benefit children with brain tumors.